Department of Orthopaedic Surgery, Handan Central Hospital, Handan, 056000, Hebei, People's Republic of China.
Hebei North University, Zhangjiakou, 075000, Hebei, People's Republic of China.
J Orthop Surg Res. 2022 Feb 5;17(1):77. doi: 10.1186/s13018-022-02972-2.
The objective of this study was to investigate the prevalence of preoperative deep venous thrombosis (DVT) in the pelvic cavity and lower extremities following pelvic and acetabular fractures and to identify the risk factors of the occurrence of DVT. Duplex ultrasound (DUS) screening and blood tests were conducted in patients admitted from June 2012 to December 2020 for surgical treatment of pelvic and acetabular fractures. Univariate analyses were performed on data of demographics, comorbidities, time from injury to surgery, injury mechanism, accompanied injury, and laboratory results. The optimal cutoff values of continuous variables with statistical significance were obtained by using the receiver operating characteristic (ROC) curve. A multivariate logistic regression analysis was then employed to examine the independent values in terms of predicting preoperative DVT. A total of 607 patients with pelvic and acetabular fractures were included, among whom 82 (13.5%) patients sustained preoperative DVTs. Specifically, 31.7% (26/82) were diagnosed with proximal DVTs. Fifty-two (63.4%) patients had DVT within 7 days after injury, and 67 (81.7%) patients within 10 days. The multivariate logistic regression analysis identified 6 factors independently associated with the presence of preoperative DVT, including age > 46 years (odds ratio [OR] = 2.94), BMI > 26.73 kg/m (OR = 3.91), time from injury to surgery > 9 days (OR = 5.39), associated injury (OR = 7.85), ALB < 32.8 g/L (OR = 2.71) and FIB > 3.095 g/L (OR = 3.34). Despite the modern prophylactic regimen, the preoperative DVT in patients with pelvic and acetabular fractures still draws the attention of orthopaedic surgeons. Better understanding these risk factors can help surgeons refine the risk stratification profile and perform early interdisciplinary management for patients at high risk of DVT.
本研究旨在探讨骨盆和髋臼骨折患者术前盆腔和下肢深静脉血栓形成（DVT）的发生率，并确定 DVT 发生的危险因素。对 2012 年 6 月至 2020 年 12 月因骨盆和髋臼骨折接受手术治疗的患者进行了双能超声（DUS）筛查和血液检查。对人口统计学、合并症、从受伤到手术的时间、损伤机制、伴随损伤以及实验室结果的数据进行了单因素分析。使用受试者工作特征（ROC）曲线获得具有统计学意义的连续变量的最佳截断值。然后进行多变量逻辑回归分析，以检查预测术前 DVT 的独立值。共纳入 607 例骨盆和髋臼骨折患者，其中 82 例（13.5%）患者术前发生 DVT。具体而言，82 例患者中 31.7%（26/82）为近端 DVT。52 例（63.4%）患者在受伤后 7 天内发生 DVT，67 例（81.7%）患者在 10 天内发生 DVT。多变量逻辑回归分析确定了 6 个与术前 DVT 存在独立相关的因素，包括年龄＞46 岁（比值比[OR]＝2.94）、BMI＞26.73kg/m（OR＝3.91）、从受伤到手术的时间＞9 天（OR＝5.39）、合并损伤（OR＝7.85）、ALB＜32.8g/L（OR＝2.71）和 FIB＞3.095g/L（OR＝3.34）。尽管采用了现代预防方案，但骨盆和髋臼骨折患者的术前 DVT 仍引起了骨科医生的关注。更好地了解这些危险因素有助于外科医生完善 DVT 高危患者的风险分层概况并进行早期跨学科管理。
